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Wisdom tooth removal is considered to be more technique sensitive than any other kind of extraction. As a result, the likelihood of post-operative complications is increased. We outline some common complications and the best way to prevent them.

Wisdom teeth are the third and last molars on each side of both jaws. These third molars are the last teeth to develop and erupt into the mouth. As a result, they can often be cramped for space and cause plenty of pain and discomfort [1].

The answer? Wisdom tooth removal. Since we technically lo longer need these wisdom teeth, they are removed when they start causing problematic symptoms or even before to prevent the occurrence of these symptoms at all.

This is where the nightmares start for most people. Even though wisdom teeth extractions are carried out routinely around the world, they are more demanding than regular extractions and can sometimes lead to post-operative complications [2]. Infection after wisdom tooth removal is the most common symptom, however, they are others which can be more damaging as well. We will outline the 5 complications you need to be wary of and everything you need to prevent them.

5 Complications after wisdom tooth removal

Dry Socket

An extraction socket, or the empty space left in the bone behind after the tooth has been removed, begins to heal through the formation of a blood clot. It is very important that this blood clot not be disturbed since it helps attract various biological molecules that help in beginning the healing process.

In some cases, though, this clot can be dislodged and the underlying bone becomes exposed. The bone then becomes exposed and is excruciatingly painful to the patient. This condition is called a dry socket [3]. Most commonly, a dry socket is established 3-5 days after the extraction procedure has been completed.

The reasons why the blood clot can get dislodged include infection, forceful rinsing after the procedure, spitting blood continuously after the extraction, cigarette smoking, and poorly controlled diabetes [4].

The best way to prevent a dry socket is to maintain good oral hygiene, avoid spitting or rinsing forcefully for at least the first 72 hours after the procedure, not smoking, and keeping control of your systemic conditions [5].


Infection after wisdom tooth removal is very common and can be a huge problem for the patient. People that are suffering from a condition that reduces their immune levels like diabetes, HIV, or others are much more likely to develop postoperative problems. Similarly, people that had a poor level of oral hygiene before the procedure are also prone to developing wisdom tooth removal infection [6].

Sometimes, poorly sterilized instruments can also cause infection but that is not really something the patient can control.

The best way to prevent post-operative infection after wisdom tooth removal is to maintain good oral hygiene and ensuring that the prescribed antibiotics are taken as directed. Patients should also avoid eating food that is abrasive, very spicy, or mixes that can get stuck inside the socket [7].

Smoking should be avoided completely until the healing of the socket has been completed.

Nerve Injury

The incidence of nerve injury while getting a wisdom tooth extraction done is pretty rare but it can happen. The lower wisdom tooth can be in close approximation to the nerve that provides sensation to the entire lower jaw. A difficult extraction in which a lot of bone cutting has to be done can cause some damage to the nerve [8].

This is a complication that is generally caused by operator error, although, in some cases, it is unavoidable due to the position of the tooth. Patients may feel a little bit of numbness or tingling sensation in their chin, lip, tongue etc which resolves on its own or they may lose sensation on the half that the extraction was done permanently in the worst case scenario [9].

Patients will be told about the potential complications and every effort is made to try and avoid it from occurring at all. Ideally, if the feeling in the side where the extraction does not return even 24-48 hours after the procedure then get in touch with your doctor.

Nerve injury is very difficult to treat and all the doctors can do is to provide some nutritional supplements and wait for nature to heal the wound on its own.


Our teeth are surrounded by a rich network of blood vessels and so the risk of bleeding exists with every extraction. In the case of the wisdom teeth, particularly the lower ones, a few major blood vessels can get injured. Such an event will lead to uncontrolled bleeding [10].

Patients must report back to the doctor immediately so that appropriate measures can be taken. The use of direct pressure, clotting agents, stitches, electrosurgical instruments or lasers to stop the bleeding may be necessary [11].

As a patient, if you are suffering from a bleeding disorder, then it should be told to the dentist well in advance so that all the measures to prevent excessive bleeding can be taken and the surgery planned accordingly.

Damage to the sinus

The upper wisdom teeth can sometimes be in close approximation to the sinus or even have roots extending beyond the sinus floor. During the wisdom tooth removal, it is possible that the sinus floor gets fractured and comes in direct contact with the oral cavity [12]. All that has to be done in such a case is for the doctor to use stitches to close up the sinus once again and put the patient on medication.

As a patient, you must understand that the likelihood of a sinus infection setting in is increased, some amount of swelling on the face will be seen, and some pain may also persist for longer than the usual duration.

This can be minimized by using a cold compress, taking the prescribed painkillers and antibiotics religiously, as well as by avoiding any strenuous physical activity like yoga or weight lifting for two weeks after the extraction has been completed.    

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